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ARCHIVED REPORTS_XR0008249
EnvironmentalHealth
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WEBER
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1149
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2900 - Site Mitigation Program
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PR0545005
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ARCHIVED REPORTS_XR0008249
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Entry Properties
Last modified
12/3/2019 2:49:19 PM
Creation date
12/3/2019 2:41:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008249
RECORD_ID
PR0545005
PE
3528
FACILITY_ID
FA0025603
FACILITY_NAME
SAN JOAQUIN BEVERAGE
STREET_NUMBER
1149
Direction
W
STREET_NAME
WEBER
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
1149 W WEBER ST
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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b FORWARD, INC. NON HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 01376 <br /> Generator Bank of Stockton Gerinrat, ng t n(-z-ion 1141) N: Wr- hr-r <br /> Address _952-09 <br /> Phone _ Za <br /> { a� 94 1 1175 Contact John (Jr-ut <br /> Transporter M P Cn,. ; ronmenta 1 Ser ✓,cn_s �- c <br /> Address 1400 r Rnl.A l n <br /> Phone ( 31 ) 560 - 0316 Contact rd <br /> I hereby certify that the above nar�i�Ria,�,pria eked up at the generator site listed above <br /> Driver Signature <br />' Shipment Date `'ZL <br /> Truck No D A Load No <br /> 1 i <br /> Vehicle License No/State /� �-- <br /> ►sultant/Contractor __?_jnfn-_-Fnvir-nnrmmnta]___ - <br /> Address P. n- Oox 2013 , Folsom, Ca . 95630 f <br />' Phone ( 91 Q R 3 - 9241 —Contact Ron n I rl K . R;n e h art_ — <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper condition <br /> for transp ccordi o app cab �r�egul ti ns <br /> Name Date d �' <br /> I � <br /> Destination Forward,IncAr <br /> -� <br /> 9999 SouthAusti� Road, Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by. 1 4 <br /> Date <br /> Acceptance No 92 174 <br /> This load contains soil with <br /> I Diesel Contaminate Yess than 104m <br /> PP greater than 100 ppm <br /> OPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> TRY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4296 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DA1 ASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yards Per this Load <br /> I <br /> TRANSPORTER COPY <br />
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